# Hernia Repair > Citation bundle for Hernia Repair on The Treatment Registry. > URL: https://thetreatmentregistry.com/procedures/hernia-repair > Bundle URL: https://thetreatmentregistry.com/api/citations/procedures/hernia-repair - Category: general-surgery - Average recovery: 14 days - Typical sessions: 1 - Price range (USD international): $1,500–$6,000 ## Description Hernia repair surgically corrects a protrusion of tissue (most commonly fat, omentum or bowel) through a weakness in the abdominal wall. The most common varieties are inguinal (groin), femoral, umbilical, epigastric, and incisional hernias; surgical principles are similar across all but operative approach varies. Two main techniques exist: open repair, in which the surgeon accesses the hernia through a single incision and reinforces the defect with sutures and/or a synthetic mesh, and laparoscopic (or robotic) repair, which uses small ports and a camera to place mesh from the inside of the abdominal wall. NICE TA160 supports the laparoscopic approach for selected primary unilateral inguinal hernias and for bilateral and recurrent cases, where it is associated with faster return to activity at the cost of slightly longer operating time. The choice of approach depends on hernia type, size, prior surgery, patient comorbidity and surgeon experience. Synthetic mesh has become the standard of care for most adult repairs because of materially lower recurrence rates than primary suture repair, though the trade-off is a small risk of mesh-related chronic pain or infection. ## Overview A hernia occurs when an organ or fatty tissue protrudes through a weak point in the surrounding muscle or connective tissue. Inguinal hernias are the most common type, followed by umbilical, incisional, and hiatal hernias. Surgical repair is the definitive treatment, as hernias do not resolve spontaneously and carry a risk of incarceration or strangulation. Two primary surgical approaches are used. Open repair involves a single incision over the hernia site, reduction of the protruding tissue, and reinforcement with synthetic mesh. Laparoscopic repair uses three small incisions and a camera to perform the same correction. Laparoscopic repair generally offers faster recovery and less post-operative pain but requires general anaesthesia. The mesh vs. non-mesh debate remains active. Mesh repair significantly reduces recurrence rates but introduces a foreign body that carries its own complications, including chronic pain and mesh migration. Many hernia repairs are performed as day-case surgery, with patients discharged the same day. The patient experience differs meaningfully between the two approaches. Open repair under local anaesthesia is feasible for straightforward inguinal hernias and allows same-day discharge in most cases. Laparoscopic repair requires general anaesthesia and insufflation of the abdomen with carbon dioxide gas, which can cause temporary shoulder-tip pain and bloating. However, laparoscopic patients typically report less incisional pain, faster return to normal activities, and lower rates of chronic groin pain compared with open mesh repair. For bilateral inguinal hernias, laparoscopic repair is generally preferred as both sides can be addressed through the same three port sites without additional incisions. Recurrence rates are the principal long-term outcome measure. Modern mesh-reinforced repair — whether open or laparoscopic — achieves recurrence rates below 2% in most published series, a substantial improvement over historical tissue-only repair rates of 10–15%. Surgeon volume correlates with outcomes: high-volume hernia surgeons consistently demonstrate lower complication and recurrence rates. Patients should enquire about the surgeon's annual caseload and whether the facility maintains a hernia-specific outcomes registry. ## Peer-reviewed outcome rates - **Complication rate:** 5.00% (range 2.00–10.00%) — from 1 cited source - **Revision rate:** 3.00% (range 1.00–5.00%) — from 1 cited source ## Common risks - Chronic pain at the repair site - Mesh-related complications (infection, migration) - Recurrence of the hernia - Seroma or haematoma formation - Injury to surrounding structures ## FAQs ### Does a hernia need to be repaired immediately? Not necessarily. Small, asymptomatic hernias may be managed with watchful waiting, particularly in elderly patients where surgical risk outweighs benefit. However, hernias that cause pain, are enlarging, or show any sign of incarceration — where the protruding tissue becomes trapped — require prompt surgical attention. ### Can a hernia come back after surgery? Recurrence is possible but uncommon with modern mesh-reinforced repair, with rates below two per cent in most published series for primary inguinal hernias. Risk of recurrence is higher for complex, recurrent, or incisional hernias. Avoiding heavy lifting during the recovery period supports durable healing. ### What is the difference between laparoscopic and open hernia repair? Open repair uses a single larger incision directly over the hernia site, which can be performed under local or general anaesthesia. Laparoscopic repair uses three small port incisions and a camera, requires general anaesthesia, and generally results in less post-operative pain, faster recovery, and lower rates of chronic groin pain. ### Is mesh safe for hernia repair? Synthetic mesh has been used in hernia repair for decades and has substantially reduced recurrence rates compared with tissue-only repair. Most patients experience no mesh-related problems. A small proportion develop chronic pain or, rarely, mesh migration or infection, which may require further surgery. Biological and lightweight meshes have been developed to reduce these risks. ### Will I have a scar after hernia surgery? Open repair leaves a scar at the incision site — typically three to six centimetres for inguinal hernias — which fades over twelve to eighteen months. Laparoscopic repair produces three small port-site scars, each approximately one centimetre, which are often barely visible once healed. ### When can I return to work after hernia repair? Most patients return to desk-based or light work within one to two weeks of laparoscopic repair and two to three weeks after open repair. Jobs involving heavy manual labour or lifting may require four to six weeks off work to allow the repair to consolidate. ### What does a hernia feel like? Most hernias present as a visible or palpable bulge, typically in the groin, navel, or at a previous surgical scar, that may become more prominent on standing or straining. They may cause a dragging discomfort or aching sensation, particularly after prolonged activity. Some hernias are discovered incidentally without symptoms. ### Can hernia repair be done under local anaesthesia? Open inguinal hernia repair can be performed safely under local anaesthesia with or without sedation in suitable patients, particularly those with medical conditions that increase the risk of general anaesthesia. Laparoscopic repair requires general anaesthesia. Local anaesthetic repair is associated with shorter hospital stay and faster return to normal activities in selected patients. ## Alternative treatments - **Laparoscopic hernia repair** — Minimally invasive alternative; faster return to activity, slightly higher cost. - **Watchful waiting** — Appropriate for small, asymptomatic inguinal hernias; small risk of incarceration. - **Truss / supportive garment** — Symptomatic management when surgery is contraindicated; not a definitive treatment. ## Sources - [Cochrane Database — Open versus laparoscopic mesh repair for primary unilateral inguinal hernia](https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001785.pub2/full) — Cochrane Database of Systematic Reviews (accessed 2026-05-09) - [WHO Surgical Safety Checklist](https://www.who.int/teams/integrated-health-services/patient-safety/research/safe-surgery) — World Health Organization (accessed 2026-05-09) - [NICE TA160 — Laparoscopic surgery for inguinal hernia repair](https://www.nice.org.uk/guidance/ta160) — National Institute for Health and Care Excellence (accessed 2026-05-09) - [RCoA — Guidelines for the Provision of Anaesthetic Services (GPAS)](https://www.rcoa.ac.uk/standards-of-clinical-practice) — Royal College of Anaesthetists (accessed 2026-05-09) - [European Hernia Society — Guidelines on the Treatment of Inguinal Hernia in Adult Patients](https://www.europeanherniasoc.eu/guidelines) — European Hernia Society (accessed 2026-06-29)